- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- London School of Hygiene and Tropical Medicine, London, UK
This work describes the analysis of household cohort data collected over a period of 6 months covering an epidemic of respiratory syncytial virus (RSV). The data was collected from a rural coastal community in Kenya in 2009.The aim of the analysis is to gain a better understanding of RSV transmission for the purpose of intervention planning. Most of this work was done as part of my doctoral project, the complete thesis can be accessed at the following link: https://doi.org/10.17037/PUBS.04656186. There are three main parts to this analysis:
Analaysis of the social-temporal shedding patterns of RSV. The aim of this analysis was to identify determinants of RSV infection onset. We show that household size, symptom status and viral load are important factors of within household transmission. We find evidence of the possible existence of an RSV group specific transmission niche that could form part of the explanation for RSV A and B temporal and geographical co-existence. This work has been published in the Epidemics journal and can be found at the following link: https://doi.org/10.1016/j.epidem.2018.12.001.
Analaysis of the social-temporal and genetic shedding patterns of RSV. This is an extension of Part 1 that aimed to identify generalizable characteristics of RSV transmission chains at the household level. and identify if data integration, and hence increased pathogen resolution, increases the precision with which model parameters are estimated or changes the estimates such that different transmission dynamics are inferred. We found that nearly half of the RSV infections in this study were acquired within the household. We showed explicitly that most infants were infected by an older sibling or cousin of school going age (2 to 13 years). We found that increased pathogen resolution had a slight effect on both accuracy (resulting in narrower credible intervals for some parameters) and model inference (resulting in a change of transmission hypothesis) The differences in infection patterns and interaction through modifiedsusceptibility inferred between RSV-A and RSV-B warrant further investigation. A pre-print version of this work is available on medRxiv https://www.medrxiv.org/content/10.1101/2020.03.08.20030742v1.
Analysis of social-temporal shedding patterns of RSV, rhinoviruses and endemic coronaviruses. This is an extension of Part 1 that aimed to investigate if the observed patterns of RSV shedding are influenced by interactions between the different pathogens circulating in the households.